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aCvrty"CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMl°DiYYYY)
<br />OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />711 512016
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER
<br />CONTACT
<br />NAME: Pam E=SCh
<br />Higginbotham
<br />1300 Tenth Street
<br />PHONE .940-723_-0.771 FAX 940-723-5309
<br />_ - (AJC. Not:..
<br />Wichita Falls TX 76301
<br />E-MAIL ... @ g9Inbotham.net
<br />ADDRess: pesch@higginbotham.net
<br />,1EtdEhAL$2.0120,000FR-
<br />INSURER(S) AFFORDING COVERAGE
<br />---
<br />INSURER A:Mid-Cont nent Insurance Company
<br />INSURED OAKRII
<br />INSURER B:T_ eXas Mutual Insurance Compal 2.2945
<br />Oakridge Energy Inc
<br />A AUTOMOBILE
<br />4513 Jacksboro Hwy
<br />C
<br />-INSURER- -
<br />Wichita Falls TX 76302
<br />INSURER D' m
<br />INSURERE :
<br />INSURER F :
<br />COVERAGES CERTIFICATE NUMBER: 24381440 Pz 111clnnt NJlinniar;P&
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT
<br />OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br />EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAYHAVE BEEN REDUCED BY
<br />PAID CLAIMS.
<br />INSR 'ADIIC'SDBR- _ T-pQLgC, BFF
<br />LTR i TYPE OF INSURANCE INSO N`Vp PDLICY NUMBER MMJDDJYYYY
<br />POLICY ffTp_ --
<br />MJDDMYY LIM17S
<br />Ax COMMERCIAL GENERAL41ABIL17Y 04GL000942551 121raf2ols
<br />1216/2016 E,,�,,.,-iiF' .,^d=E $1,000.000
<br />=L Ita ;-tnAOE x
<br />AI"1- E T w-
<br />FF'Ei;dGE;:Ea-$100,004
<br />X 1 1.000
<br />kIF-D E'aP (Ary one pe wn1 $
<br />--
<br />PEPS -NAL,a hGV IPdJJRY $1,004,440
<br />,,FN'LLI— REGATELIMITAPPLE7--LF' j
<br />,1EtdEhAL$2.0120,000FR-
<br />RriL[cY ❑ C
<br />---
<br />JE'CGT L'�i.
<br />PPOCiUr:TS- $2,000,_000
<br />-.THFR
<br />$
<br />A AUTOMOBILE
<br />LIABILITYCOMBINED
<br />06CA002611832 12!5!2415
<br />12/6=16
<br />�IN,L LI A1-
<br />91,000,000
<br />i
<br />(F3ar.,dent)
<br />X
<br />LTJ'f LUT, ;
<br />!
<br />B, -,[)IL' iNJUR': {Per perscnI 5 - —
<br />i
<br />�LLS1:4dED SI-HECULEG
<br />At 1Tt7.9
<br />Ei QIL{ INJUR'r {Per aci olerr
<br />,VWED
<br />HIFEDAUTu gUT,3�
<br />FF -17177 YDAfdP,i=F $
<br />�.-a
<br />Pei � ei dent}
<br />- -
<br />3
<br />A UMBRELLALIAS_=UR
<br />F -{
<br />04XS193863
<br />12!5!2415
<br />121512016
<br />EACHOLD-URREN�CE $1,000,000
<br />- X EXCESS LIAB :'t AIM. -MADF
<br />A=.;�,RF�;,4TE $1,000,000
<br />-
<br />x T
<br />$
<br />Fr Erlr,rl,:J,1D.Do0
<br />JB I VlORf4ER$£OMPENSAT{ON -
<br />{ M 027 j2'{" 7/14/2016
<br />7/'F4f24'I
<br />AND EMPLOYERS' LIABILITY
<br />YIN
<br />I
<br />. TE EP
<br />SEL'' H.aC _',GENT j ,1,44Q044
<br />Ji E'I-' FOIE � F �' INEPf--- LTI.--
<br />I �E ❑ NIA
<br />FFIk
<br />AGED
<br />�(Mandatory En NH)
<br />L L r.11 E'er -t `p � MPL }YEE 51,000,000
<br />DES. IF'Tli:;^J F FEk -; hJ__,R,,^-
<br />CL y,E='E- _L Y,_IP11T $9,090,000
<br />I V
<br />DESCRIPTION OF OPERATIONS f LOCATfONS! VEHICLES (ACC RD 101, Additiona3 Remarks Schedule, may be attached if more space is required)
<br />Colorado Division of Reclamation
<br />CERTIFICATE HOLDER CANCELLATION
<br />Savage &Sava e
<br />4610 Haystack Drive
<br />Windsor CO 80550
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NOTICE IMILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />AUTHORIZED REPRESENTATIVE
<br />x
<br />O 1988-2014 ACORD CORPORATION. All rights reserved.
<br />ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD
<br />
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